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Provider Information for 1689685570


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CINDY JOHNSON LPC


Sex: Female

NPI: 1689685570
Last Updated: 2007-07-08
Certification Date:

Details

NameValue
NPI1689685570
Enumeration Date2006-08-10
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address PO BOX 1108
TEMPLE, TX 76503-1108
United States

Phone: 254-773-4022 | Fax:254-773-0919
 
Primary Practice Address 3010 SCOTT BLVD STE 103
TEMPLE, TX 76504-6803
United States

Phone: 254-773-4022 | Fax:254-773-0919
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDTX028229503
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthTX15888TX